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All correspondence to:
Chatterbox
Les côtes sud
74910 Seyssel
Tel.: 0450567640
Cell: 0620735560
Email : [email protected]
IMMERSION COURSES
Registration Form
Dates : from Monday ……………. at 09h00 to Friday ……………….. at 17h00
from Friday ………............ at 18h00 to Sunday …………….. at 17h00
The student
Family name:
First name:
Date of birth:
Class: (for children)
Address:
Telephone number:
Email address:
Current level of English:
Beginner
Smattering
Average level in written and spoken English
High level in written and spoken English
Very Fluent
Chatterbox
Association Loi 1901
1 rue de la Fraternité, 74000 Annecy
No. Siret 42867775100011
Déclaration d’activité enregistrée sous le numéro 82 74 02348 74
auprès du préfet de région de Rhône-Alpes
Legal guardian (for minors)
Family name:
First name:
Address:
Telephone number:
Email address:
Medical disclaimer
I, the undersigned, ……………………………………………………………………,*
legal guardian/tutor of ………………………………………….............…………
authorise the organisers of Chatterbox to undertake whatever medical decision they feel
necessary, should the need arise.
Signature:………………………………..
Date:………………………
Chatterbox
Association Loi 1901
1 rue de la Fraternité, 74000 Annecy
No. Siret 42867775100011
Déclaration d’activité enregistrée sous le numéro 82 74 02348 74
auprès du préfet de région de Rhône-Alpes
Rules:
5 day courses
I enclose 2 cheques for a total of € 650 with the Registration Form.
1 cheque for € 500 payable to the Host family
1 cheque for € 150 payable to Chatterbox
Weekend course
I enclose 2 cheques for a total of € 270 with the Registration Form.
1 cheque for € 200 payable to the Host family
1 cheque for € 70 payable to Chatterbox
NB. Incomplete dossiers will NOT be accepted.
The price of the course includes conversation with the host family from morning until night
and full board lodging and accommmodation. If you wish to have individual tuition, we can
arrange a specific programme for you. Extra activities and lessons will be charged
separately.
Chatterbox
Association Loi 1901
1 rue de la Fraternité, 74000 Annecy
No. Siret 42867775100011
Déclaration d’activité enregistrée sous le numéro 82 74 02348 74
auprès du préfet de région de Rhône-Alpes